The levels, prevalence and related factors of compassion fatigue among oncology nurses: a systematic review and meta‐analysis

Abstract

Background Compassion fatigue is described as the phenomenon of exhaustion and dysfunction in healthcare workers resulting from prolonged exposure to work‐related stress and compassion stress. Oncology nurses are at high risk for compassion fatigue. Aims Our study aims to estimate the levels, prevalence and related factors of compassion fatigue dimension in oncology nurses. Design Systematic review and meta‐analysis. Method Ten electronic databases were conducted in the systematic review and meta‐analysis. Time frame of the searches is from inception up to 31 January 2020. The research team independently conducted study selection, quality assessments, data extractions and analysis of all included studies. The means, standard deviations and prevalence of three dimensions of compassion fatigue were pooled using random‐effects meta‐analysis. The PRISMA guideline was used to report the systematic review and meta‐analysis. PROSPERO registration number: CRD42020205521. Results The systematic review included 21 studies, involving 6533 oncology nurses across 6 different countries. In our studies, the pooled mean scores of compassion satisfaction (CS), burnout (BO) and secondary traumatic stress (STS) were 35.47 (95% CI: 33.54–37.41), 24.94 (95% CI: 23.47–26.41) and 24.48 (95% CI: 23.36–25.60), respectively; the pooled prevalence of “low” rates of CS, “high” rates of BO and STS were 20% (CI 13%–28%), 22% (CI 18%–26%) and 22% (CI 17%–28%), respectively; furthermore, geographical regions (Asia) significantly affect the prevalence of compassion fatigue among oncology nurses. The compassion fatigue variables considered were demographic (age, marital status, education background, health condition and gender), work‐related (job satisfaction, income satisfaction, years of working experience, professional title, position and work environment) and other variables (social support, coping strategy, self‐compassion, professional cognition and psychological training). Conclusion Oncology nurses were at “moderate” level of compassion satisfaction, burnout and secondary traumatic stress, and 22% of oncology nurses suffered from “high” risk of compassion fatigue. Hospital administrators should develop interventions to address compassion fatigue phenomenon, and enhance the mental health of oncology nurses and nursing care results. Relevance to clinical practice Oncology unit warrants special attention, and oncology nurses are at high risk for compassion fatigue. However, the reported prevalence rates and oncology nurses with different characteristics vary considerably. The review provides a preliminary framework for nursing administrators to develop interventions to address compassion fatigue phenomenon, and enhance the psychological health of oncology nurses.

Resilience as a mediator between compassion fatigue, nurses' work outcomes, and quality of care during the COVID-19 pandemic

“…As nurses' age and years of work experience increased, their risk of experiencing CF decreased. This result supports findings from a vast number of studies during the pre-pandemic period in which nurses' age and years of nursing experience were strongly linked to CF ( Alharbi et al, 2020a , Alharbi et al, 2020b , Alharbi et al, 2020c ; Sacco, Ciurzynski, Harvey, & Ingersoll, 2015 ; Xie et al, 2021 ). For instance, an integrative review by Alharbi et al (2019) found that younger nurses experienced a higher level of CF than older nurses, while cross-sectional studies in China, Korea, the US, and Saudi Arabia identified age and work experience as important risk factors for CF ( Alharbi et al, 2020a , Alharbi et al, 2020b , Alharbi et al, 2020c ; Sacco et al, 2015 ; Xie et al, 2021 ).…”

“…Prior to the pandemic, the prevalence of CF in nurses ranged from 22% to 60% ( Ortega-Campos et al, 2020 ; Xie et al, 2021 ), while during the initial surge of the coronavirus crisis, the prevalence reached 70% ( Erkin et al, 2021 ). In the current study, 38.6% of frontline nurses experienced medium to high CF.…”

“…Age, marital status, education, gender, salary, ethnicity, and overall health condition were identified as personal factors associated with CF. Work-related factors included years of work experience, job rank, job status, work climate, and presence of violence in the workplace; psycho-social factors strongly linked to CF included family support, coping skills, psychological distress, and professional identity ( O'Callaghan, Lam, Cant, & Moss, 2020 ; Xie et al, 2021 ). Manifestations of CF include decreased energy, reduced ability to empathize, increased hopelessness, and heightened emotional exhaustion ( Peters, 2018 ).…”

Prevalence and contextual factors associated with compassion fatigue among nurses in northern Uganda

“…Other studies show that the prevalence of compassion fatigue in nurses ranges from 21.6% to 44.8% depending on the area to which they are assigned such as emergency and ecology [ 1 ]. A systematic review involving 6533 nurses across six different countries showed that 24.48% of the respondents had high levels of compassion fatigue [ 18 ].…”

“…The prevalence of compassion fatigue has been linked majorly to personal factors like gender, and working experience [ 18 , 24 , 25 ]. Organizational risk factors linked to compassion fatigue include work overload, low remunerations, unsupportive peers, lack of control, and ineffective supervision [ 18 ]. Other factors include coping strategy, self-compassion, social support, and professional cognition [ 18 , 24 , 25 ].…”